Self-report depressive symptoms are dissociated from tremor severity in essential tremor

Parkinsonism Relat Disord. 2018 May:50:87-93. doi: 10.1016/j.parkreldis.2018.02.031. Epub 2018 Feb 20.

Abstract

Background: Depressive symptoms are associated with essential tremor (ET). However, the relationship between cognitive, functional, and motor measures with depressive symptoms in ET is not yet understood.

Methods: The following measures were cross-sectionally assessed in a group of 223 subjects with ET: the Montreal Cognitive Assessment (MoCA) Scale, the Lawton Independent Activities of Daily Living (IADL) Scale, a neurologist assessment of tremor severity, and the Geriatric Depression Scale (GDS).

Results: 20% (44) of the subjects met GDS criteria for depression (GDS ≥ 10). 43% (94) of the subjects showed at least some cognitive impairment (≤24 on the MoCA), and 15.3% (34) reported significant functional impairment (IADL score < 7). There was no significant association between GDS score and tremor scale score. The total GDS was negatively associated with the total MoCA score (Spearman's r = -0.15, p = 0.03). The total GDS was also negatively associated with the IADL score (Spearman's r = -0.19, p = 0.02), (logistic model odds ratio, OR = 4.91, p < 0.01). Over 60% of subjects who were depressed, per GDS cut-off score (≥10), were not receiving medical treatment for depression.

Conclusions: There was a high point prevalence of depressive symptoms in subjects with ET. Self-report depressive symptoms are dissociated from tremor severity. Hence, these data do not support the hypothesis that depression in ET represents a psychological reaction to the tremor. There appears to be a clustering of cognitive, functional, and depressive symptoms in ET. Screening of depression in ET can improve our understanding and treatment of this disorder.

Keywords: Clinical; Cognition; Depression; Essential tremor; Function; Tremor.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognitive Dysfunction / etiology
  • Cognitive Dysfunction / physiopathology*
  • Cross-Sectional Studies
  • Depressive Disorder / etiology
  • Depressive Disorder / physiopathology*
  • Diagnostic Self Evaluation*
  • Essential Tremor / complications
  • Essential Tremor / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Self Report
  • Severity of Illness Index